Truth and Reconciliation: An Evening of Sharing and Healing

On Wednesday, March 20, 2016, Rethinking Psychiatry collaborated with The M.O.M.S. Movement and The Icarus Project to host our first Truth and Reconciliation Circle for Receivers and Givers of Psychiatric and Mental Health Services. In this three-hour event, both receivers and givers of psychiatric and mental health services expressed their thoughts and feelings in a structured, facilitated environment.

The Truth and Reconciliation process is complex and nuanced. Its original intent is to address power imbalances, give a voice to the oppressed, and provide an opportunity for all involved to speak their truths bravely. For those who have been hurt, it is powerful to be heard by people in positions of power; and for those in power, the transformative effect is in understanding the impact of their actions by those who have been affected similarly.

A form of restorative justice, the Truth and Reconciliation process, was brought to the international community in the aftermath of apartheid in South Africa. It has been used in a wide variety of settings to achieve reconciliation in some of the world’s worst human rights abuses.

So why did we pick the format of a Truth and Reconciliation project for the receivers and givers of the mental health system? Some people believe the parallel fits perfectly: that the psychiatric system is fundamentally a system of control, oppression, and gross injustice. Other people think there are instances of harm, but the system is mostly designed to help people. Rethinking Psychiatry chose this format because, though we have differing beliefs along that continuum, we agreed that creating a space where people could speak the truth of their experiences–on all sides–is critical for everyone involved. It is our hope that the community will then use this to effect systemic change.

The idea to use Truth and Reconciliation circles for people involved with the mental health system came from one of Rethinking Psychiatry’s founding members and the founder of the M.O.M.S. Movement, Cindi Fisher. Fisher’s adult son suffered tremendous injustice and discrimination in the mental health system, and his symptoms only got worse as a result of the treatment he received. Fisher discovered that situations like her sons were all too common. Eventually, it inspired hervision for this event. Fisher then turned to members of The Icarus Project to help develop the format and flesh out the details. Icarus is a radical mental health support and activist group, and Fisher knew that this work should not be attempted without leadership from the people most affected.

A lot of thought and discussion went into planning the Truth and Reconciliationevent. We knew that we were dealing with a very complex, controversial, and emotionally loaded topic. We knew it was going to be a delicate balancing act. We wanted to ensure openness, but we didn’t want anyone to feel pressured to share more than they were comfortable sharing. We wanted people to feel free to express their emotions, including anger while ensuring that the space was as respectful as possible. We wanted to allow receivers and givers of mental health services to speak their truths, but we did not want to replicate the power imbalances and oppression that are inherent in the system. And we knew that while there were people who identified as receivers and individuals who identified as givers, many there identified as both and rarely had a chance to be open as such.

Our facilitators began by leading a moving meditation exercise and a light-hearted icebreaker to help the group ease into the activity. Our facilitators also clearly explained the purpose and structure of the group before the discussion began. Then, receivers of mental health services were invited to sit in an inner circle and share their thoughts and feelings about their experiences, while the rest of the group sat in an outer circle. Afterward, givers of mental health services were invited into the inner circle to do the same. People who identified as both receivers and givers were welcome to join both circles. We also made it clear from the beginning that it was all right if participants chose not to speak at all, and it was okay if members chose not to join either of the inner circles.

Information on healing from trauma usually mentions the importance of creating a “container” for painful emotions, pacing oneself, and using healthy coping strategies to avoid “flooding” (becoming overwhelmed with emotions related to the trauma). These principles were embedded in our Truth and Reconciliation process.

We were concerned that participants who experienced trauma in the psychiatric system could be triggered by hearing specific details of other people’s trauma. Besides, the time frame did not allow for lengthy sharing. Instead, we used specific questions as prompts for discussion to help participants get to the heart of what was most remarkable about their stories.

Our discussion was rich and thought-provoking, but it was clear that there are no easy answers. We plan to do Truth and Reconciliation events again in the future, and we are hoping that other groups that are rethinking the dominant mental health paradigm will use this Truth and Reconciliation model in the future. We are developing a manual to share. We hope we can host an all-day Truth and Reconciliation workshop in the future. Applying the Truth and Reconciliation model to this issue was risky, but the closing and follow up remarks of the participants made us very glad that we took the risk.

Here is a followup comment by a giver who was present (quoted with express permission):

I do think it was a healing experience, for me as a former provider as well as for many of the participants. I thought it was great for providers, some of whom were still pretty enmeshed in the medical model, to hear specifically the harm done to “patients,” especially regarding the inevitably traumatic nature of violent incarceration and enforced drugs as a means of “helping” as well as some insight into why “patients” might not be so excited about accepting their label and their intended diminished role in society as a “mental health consumer.”

I also thought it was helpful for those affected badly by the “mental health” system to hear that at least some of the providers agonized over these decisions and situations and were not unaware of the weird conflicts and bad effects of many of the standard practices in the field, and that some also were working on developing different approaches that were respectful of the needs and individuality of the participants.

And here is a comment from the closing circle from a receiver present (quoted with express permission):

“Providers need healing too. Receivers are healers too.”

On Wednesday, May 25, Rethinking Psychiatry will host a follow-up Truth and Reconciliation event, this time including families and allies of people who have experienced extreme emotional states. For more information, visit our website at http://www.rethinkingpsychiatry.org/

Notes: Truth and Reconciliation was first used in post-apartheid South Africa. It has since been employed in the aftermath of a variety of human rights atrocities. It was utilized in the aftermath of genocide in Rwanda and the aftermath of forced assimilation and abuse of indigenous children in Canada. Two of the best-known uses of Truth and Reconciliation in the U.S. were the T&R group formed on the 25th anniversary of the Greensboro massacre in North Carolina and in the aftermath of the Ferguson, Missouri police shooting of Michael Brown.

The history of Truth and Reconciliation in world affairs is controversial. For example, The Truth and Reconciliation Commission in post-apartheid South Africa was accused of “artificial even-handedness” for investigating crimes committed by both the South African state and the anti-apartheid liberation movement. Also, many people have criticized Truth and Reconciliation commissions for sometimes granting amnesty to people who committed human rights atrocities. On the other hand, it is also a process that can be profoundly healing and empowering for individuals who have survived human rights violations. The process can also be an avenue for people who honestly want to make amends.

For more information on the history of Truth and Reconciliation around the world, visit the links below.

Rachel Levy is a clinician and writer who lives in Portland, Oregon. She has been a member of Rethinking Psychiatry since 2010.

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8 COMMENTS

Truth and Reconciliation work usually happens after a struggle has been won. So I’m interested in how this work has effected both participants but also whether it has helped achieve any aims such as moving towards no forced treatment and whether it has strengthened any movement, or any other benefits.

I can see it would great personal impact on all taking part. For me I think this would be of more importance to those who were actively harmed by psychiatry as patients than to workers.

Workers might find it useful to do this to salve thier consciences and if still working in psychiatry to have more confidence in challanging mainstream practise and to have more empathy for clients. However I think most of them will still be in the position that most workers who are critical of psychiatry are of feeling trapped in a system that they are almost entirely helpless to transform. To do that they would need to work in a progressive unit, such as one practising open dialogue, or to have the support of something like The Critical Psychiatry Network.

It sounds like a worthwhile, and well facilitated venture but that to achieve any systemic change it will be a very slow processout of which other modalities might arrise.

It was commented by one of the participants, and I shared this view, that the providers who REALLY needed to be there would run a hundred miles to get away from it. I don’t think we can truly find reconciliation when the folks willing to admit to and talk about what’s really going on are marginalized and punished by the powers that be for speaking up. I think it will increase the courage of some to speak up who haven’t, but might also cause others working within the system to conclude, as I eventually did, that collaborating with the psych system is not consistent with keeping one’s on integrity intact.

I admire you for being able to continue the good fight, despite the discouraging odds. It is quite dispiriting to be “behind enemy lines” like you are, and it’s impressive you have been able to maintain your integrity despite the obvious threats to your reputation and even your employment. You are a remarkable person!

I’m curious for the same reasons. I’ve always seen Truth & Reconciliation from the South African model, as something taking place after a liberation struggle has been won, largely as an occasion for the venting of grief and grievances people had held in up till then because it would have been unsafe to do so. So I’m not sure how the “safety” factor is reconciled here, with Psychiatry Inc. still in ascendance, much less defeated.

On the other hand, all analogies have limitations. The fact that Cindi Fisher is involved with this effort gives it a degree of instant credibility with me. I don’t know anyone else in this vaguely-defined movement who has so consistently attempted to keep a clear focus on the racist practices of psychiatry in the present day, with an understanding of its origins in the days of slavery and how this extends into “modern” times.

I agree with the other commenters – not sure how “reconciliation” would work given that the oppression by establishment psychiatry largely continues.

Still, it sounds well-intended. I would have been interested to hear more direct quotes or stories from the actual conference – the article was a bit distant, removed, and theoretical. I didn’t click on all the links, partly because I wasn’t sure where to start with finding such stories.

As for establishment psychiatric treatment, I wish I had been there to give my piece about the fraud that is mainstream psychiatry. When you bring together the elements of fake diagnoses, drugs/ECT targeted to fabricated diagnoses, the ineffectiveness of such drugs in reducing suffering and improving functioning, and the obsession with coercion and with controlling risk (often of suicide) in establishment settings… it’s very hard to rationalize that psychiatrists and their lackeys do very much worthwhile at all, nor that they would not be better off eliminated.

To the author – why use the word “symptoms” to describe the troubled son in your article? … unless you believe that the person involved had a brain disease, which it sounds as if you at least doubt. The words we use matter… it’s easy enough to use a non-disease model term, like “problems” or “suffering”, instead.

Needless to say, by “eliminated” I don’t mean that psychiatrists should be killed. I mean that we would be better off if there were no psychiatrists employed, if the mental prisons were closed down, the drugging stopped, and present day mental health workers forced to retrain in professions that actually do more good than harm.